PART 3

Regulation of health and adult social care services
CHAPTER 4

Pricing

The national tariff
116
1
Monitor must publish a document, to be known as “the national tariff”, which specifies—
a
certain health care services which are or may be provided for the purposes of the NHS,
b
the method used for determining the national prices of those services,
c
the national price of each of those services, and
d
the method used for deciding whether to approve an agreement under section 124 and for determining an application under section 125 (local modifications of prices).
2
The national tariff may provide for rules under which the commissioner of a health care service specified in the national tariff and the providers of that service may agree to vary—
a
the specification of the service under subsection (1)(a), or
b
the national price of the service.
3
Where a variation is agreed in accordance with rules provided for under subsection (2), the commissioner of the service in question must maintain and publish a written statement of—
a
the variation, and
b
such other variations as have already been agreed in accordance with rules provided for under that subsection in the case of that service.
4
The national tariff may also—
a
specify variations to the national price for a service by reference to circumstances in which the service is provided or other factors relevant to the provision of the service,
b
provide for rules for determining the price payable for the provision for the purposes of the NHS of health care services which are not specified under subsection (1)(a), and
c
provide for rules relating to the making of payments to the provider of a health care service for the provision of that service.
5
Rules provided for under subsection (4)(b) may specify health care services which are not specified under subsection (1)(a).
6
The national tariff may also provide for rules for determining, where a health care service is specified in more than one way under subsection (1)(a) or in more than one way in rules provided for under subsection (4)(b), which specification of the service is to apply in any particular case or cases of any particular description.
7
The national tariff may include guidance as to—
a
the application of the method specified under subsection (1)(d),
b
the application of rules provided for under subsection (2), (4)(b) or (6),
c
the discharge of the duty imposed by subsection (3), or
d
the application of variations specified under subsection (4)(a),
and a commissioner of a health care service for the purposes of the NHS must have regard to guidance under this subsection.
8
Different methods may be specified under subsection (1)(b) for different descriptions of health care service.
9
The national tariff may, in the case of a specified health care service or health care services of a specified description, specify different national prices or different variations under subsection (4)(a) in relation to different descriptions of provider.
10
A description for the purposes of subsection (9) may not be framed by reference to—
a
whether the provider is in the public or (as the case may be) private sector, or
b
some other aspect of the status of the provider.
11
The national tariff may not specify a national price for a health care service provided pursuant to the public health functions of the Secretary of State, or of a local authority, under the National Health Service Act 2006.
12
The national tariff has effect for such period as is specified in the national tariff (or, where a new edition of the national tariff takes effect before the end of that period, until that new edition takes effect).
13
In exercising its functions under this Chapter, Monitor must (in addition to the matters specified in section 66) have regard to the objectives and requirements for the time being specified in the mandate published under section 13A of the National Health Service Act 2006.